Sporotrichosis: development and challenges of an epidemic

In the state of Rio de Janeiro, Brazil, sporotrichosis reached epidemic levels, involving humans and cats. Preliminary data indicate that approximately 2 200 human cases were diagnosed between 1998 and December of 2009, and 3 244 cats were treated. The geographic distribution of cases reveals a concentration in the City of Rio de Janeiro metropolitan area. The disease affects mostly women of a low socioeconomic status, aged 40 to 55 years, who work as housekeepers. Itraconazole has been the drug of choice for treatment. Although sporotrichosis does not usually affect organs other than the skin, mucosa, and subcutaneous tissue, it has an indirect social impact resulting from absenteeism, pain, and discomfort during the active disease stage, and the unpleasant appearance of the scars. In turn, systemic involvement is frequent in cats, leading to serious and difficult-to-treat forms of the disease and death. Considering that treatment time in animals is longer than in human beings, treating cats with sporotrichosis has been the greatest obstacle and the most important challenge for the control of this epidemic infection.